My Specialty

Telemetry Nursing: Interview with Amber Wood, RN, BSN, CCRN

Credentials matter while caring for acute cardiac patients

Amber Wood, RN, BSN, CCRN, has worked in telemetry since graduating from nursing school five years ago. After precepting in the cardiac ICU as a student nurse, her interest was piqued and she sought a position in telemetry upon graduation.

When asked what she loves most about her work, Wood said, “Most of the patients in telemetry have had open heart surgery, a heart attack or been recently diagnosed with heart failure. They’re scared and apprehensive, and you have a pivotal role in helping them to make positive lifestyle choices.”

The average stay for acute patients in her unit is two to five days, with some heart failure patients staying up to eight days. Common comordibities include heart disease, kidney disease, diabetes, hypothyroid (which can be accompanied by atrial fibrillation), and sleep apnea (which can often cause chronic heart failure when left untreated).

Most patients are discharged directly to home, so patient education must be provided simultaneously along with skilled care. “You don’t have that much time with patients because it’s so busy. You have to decide the most important points you have to make, and develop trust quickly.”

The telemetry floor at Hoag is “popular” and the hospital’s new telemetry overflow unit is also usually full. She confirmed that evidence-based practice is an essential component of her unit’s functioning, and her facility provides ongoing refresher courses and continuing education.

“It’s fast-paced, challenging work, but I love it,” said Wood.

Keeping Up With the Meds

Wood feels that the technology doesn’t change as much in telemetry as the medications used for managing cardiac patients. Wood’s unit received all new equipment one year ago, but staying abreast of new medications appears to be the true challenge. “As a good nurse you need to understand any new med that you’re giving. You must know exactly what you need to be monitoring. Most of our patients are on at least 10 meds, so you need to know what to look for in terms of interactions and counter interactions.”

When Patients Inspire Us

Not long ago, Wood was one of many nurses to take care of an elderly patient who was scheduled for open heart surgery. He had a number of postoperative challenges and setbacks, but Wood and her colleagues found his motivation to recover inspiring.

She explained that nurses often have to do “a lot of convincing” to get open heart patients out of bed and moving, but this particular patient was always calling for the nurses to take him for a walk. When he got out of bed, he insisted on doing two laps instead of one, and sometimes would push himself to do more.

Wood remarked on his kindness and gratitude, traits that endeared him to the staff, all of whom enjoyed his company while looking forward to him regaining his independence. “I really admired his tenacity and optimism, particularly in the most difficult stages of his recovery. I feel like I would have been discouraged had I been in his place.”

Advice For Those Interested in Telemetry

Wood, who belongs to the American Association of Critical Care Nurses, recommends that nurses seeking employment in cardiac nursing and telemetry seek ACLS certification since most hospitals require this credential before a nurse begins employment. She also recommends CCRN and PCCN certifications for nurses interested in cardiac and telemetry nursing.

The Basics of Telemetry Nursing

Cardiac patients are often transferred to telemetry units following acute cardiac events and surgery, and these patients generally require constant vigilance and finely honed clinical skills. In telemetry units, various devices monitor vital signs, oxygen levels, electrocardiograms and other important physiological functions. The telemetry nurse must be astute in reading, assessing and interpreting what the monitors reveal. While the monitors for these devices are generally located in a central location like a nurses’ station, the telemetry nurse also provides bedside care and regular physical assessments.

According to multiple sources, the average salary for a telemetry nurse is between $55,000 and $57,000, although travel nurses can apparently expect to earn significantly more depending on the geographic region where they are employed.

All telemetry nurses must have training in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS); others also pursue Critical Care Registered Nurse (CCRN) and Progressive Care Critical Nurse (PCCN) certifications, as well as further certifications in cardiac telemetry and critical care nursing.

Certification

The American Association of Critical Care Nurses (www.aacn.org) is a national organization that represents many nurses who work in telemetry and cardiac care. They actively encourage nurses to pursue certifications “to promote and enhance consumer health and safety by establishing and maintaining high standards of professional practice excellence.”

To qualify for CCRN certification, applicants must pass a 150-question, 3-hour certification exam, and log 1,750 hours in direct bedside care of acutely or critically ill patients within the last two years preceding the date of application, with 875 of those hours accrued in the most recent year preceding application.

Keith Carlson, RN, BSN, is a registered nurse, writer and blogger. He writes for a variety of nursing and health websites, and has been included in several nonfiction nursing books by Kaplan Publishing. He is editorial contributor to BlackDoctor.org. His own blog can be found at digitaldoorway.blogspot.com.